Determining the Correlation and Accuracy of Three Methods of Measuring Neonatal Bilirubin Concentration: Serum, Capillary and Transcutaneous Bilirubin

DOI: 10.26717/BJSTR.2017.01.000286

Received: July 29, 2017;   Published: August 21, 2017

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Abstract

Background: The gold standard to assess hyperbilirubinemia in neonates remains the serum bilirubin measurement. Unfortunately, this is invasive, painful, and costly. Trying to overcome these drawbacks, non-invasive methods of bilirubin measurements have been proposed. Our aim was to assess the agreement between capillary sample gas analyzer results, total serum bilirrubin levels and transcutaneous bilirrubin results.

Methods: the transcutaneous bilirubin (TCB) measurements were performed on the infant’s sternum and serum and capillary bilirubin were determined simultaneously. The agreement between both methods was assessed by Spearman´srank correlation coefficient.

Results: A total of 217 measurements were performed in 75infants. Median bilirrubin measurements were 6,127 mg/dl (for serum samples) 6,684 mg/dl (gasometry) and 4,371 mg/dl (TCB). A significant correlation was observed between serum samples and analyzed by gasometry (Spearman´s Rho 0,895; 95% IC CCI: 0.955). Correlation was strong but lower between serum samples and TCB (Spearman´s Rho 0,881; 95% CI CCI: 0.847) and gasometry and transcutaneous samples (Spearman´s Rho 0,914; 95% CI CCI: 0,834). Analyzing for ranges; correlation is higher in 5-9 mg/dl interval comparing serum samples and analyzed by gasometry (95% CI CCI: 0.882).

Conclusion: transcutaneous bilirubin and determined by gasometry could be alternatives to total serum for early diagnosis, proper management of the neonatal jaundice, increase quality of care, improve in parent satisfaction, and an overall decrease in hospital charges.

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